Motivational Effects of Cannabinoids Are Mediated by Μ-Opioid and Κ
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Medications to Treat Opioid Use Disorder Research Report
Research Report Revised Junio 2018 Medications to Treat Opioid Use Disorder Research Report Table of Contents Medications to Treat Opioid Use Disorder Research Report Overview How do medications to treat opioid use disorder work? How effective are medications to treat opioid use disorder? What are misconceptions about maintenance treatment? What is the treatment need versus the diversion risk for opioid use disorder treatment? What is the impact of medication for opioid use disorder treatment on HIV/HCV outcomes? How is opioid use disorder treated in the criminal justice system? Is medication to treat opioid use disorder available in the military? What treatment is available for pregnant mothers and their babies? How much does opioid treatment cost? Is naloxone accessible? References Page 1 Medications to Treat Opioid Use Disorder Research Report Discusses effective medications used to treat opioid use disorders: methadone, buprenorphine, and naltrexone. Overview An estimated 1.4 million people in the United States had a substance use disorder related to prescription opioids in 2019.1 However, only a fraction of people with prescription opioid use disorders receive tailored treatment (22 percent in 2019).1 Overdose deaths involving prescription opioids more than quadrupled from 1999 through 2016 followed by significant declines reported in both 2018 and 2019.2,3 Besides overdose, consequences of the opioid crisis include a rising incidence of infants born dependent on opioids because their mothers used these substances during pregnancy4,5 and increased spread of infectious diseases, including HIV and hepatitis C (HCV), as was seen in 2015 in southern Indiana.6 Effective prevention and treatment strategies exist for opioid misuse and use disorder but are highly underutilized across the United States. -
The Opioid Epidemic: What Labs Have to Do with It?
The Opioid Epidemic: What labs have to do with it? Ewa King, Ph.D. Associate Director of Health RIDOH State Health Laboratories Analysis. Answers. Action. www.aphl.org Overview • Overdose trends • Opioids and their effects • Analytical testing approaches • Toxicology laboratories Analysis. Answers. Action. www.aphl.org Opioid overdose crisis 1 Analysis. Answers. Action. www.aphl.org Opioid overdose crisis 2 Analysis. Answers. Action. www.aphl.org Opiates and Opioids • Opiates vs. Opioids • Opiates: Naturally occurring, derived from the poppy plant • Opioids: “Opiate-like” drugs in effects, not chemical structure Includes opiates • Narcotic analgesics • CNS depressants • DEA Schedule I or II controlled substances • Additive effect with other CNS depressant drugs Analysis. Answers. Action. www.aphl.org Efficacy of Opioids • How do opioids work? • Bind with opioid receptors • Brain, spinal cord, GI tract, and throughout the body • Pain, emotion, breathing, movement, and digestion Opioid Receptor Analysis. Answers. Action. www.aphl.org Effects of Opioids Physiological Psychological • Pain relief • Drowsiness/ sedation • Cough suppression • Mental confusion • GI motility • Loss of memory • Respiratory depression • Lethargy/ apathy • Pupillary constriction • Euphoria/ tranquility • Itching • Mood swings • Constipation • Depression • Dependence • Withdrawal • Dependence Analysis. Answers. Action. www.aphl.org Opiates 1 Opiates • Naturally occurring alkaloids Opium • Latex from the opium poppy plant Codeine: • Mild to moderate pain • Antitussive Morphine: • Severe pain • Metabolite of codeine and heroin Analysis. Answers. Action. www.aphl.org Opiates 2 Semi-synthetic Opiates: • Synthesized from a natural opiate Heroin: • Schedule I narcotic Hydrocodone (Vicodin): • Mild to moderate pain • Metabolizes to hydromorphone (Dilaudid) Oxycodone (Oxycontin/Percocet): • Moderate to severe pain • Metabolizes to oxymorphone (Opana) Analysis. Answers. Action. -
Information to Users
The direct and modulatory antinociceptive actions of endogenous and exogenous opioid delta agonists Item Type text; Dissertation-Reproduction (electronic) Authors Vanderah, Todd William. Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 04/10/2021 00:14:57 Link to Item http://hdl.handle.net/10150/187190 INFORMATION TO USERS This ~uscript }las been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely. event that the author did not send UMI a complete mannscript and there are missing pages, these will be noted Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginnjng at the upper left-hand comer and contimJing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. -
(12) United States Patent (10) Patent No.: US 9,492.445 B2 Bazhina Et Al
USOO9492445B2 (12) United States Patent (10) Patent No.: US 9,492.445 B2 Bazhina et al. (45) Date of Patent: *Nov. 15, 2016 (54) PERIPHERAL OPIOID RECEPTOR (58) Field of Classification Search ANTAGONSTS AND USES THEREOF USPC .................................................. 514/282, 289 See application file for complete search history. (71) Applicant: Wyeth LLC, Madison, NJ (US) (56) References Cited (72) Inventors: Nataliya Bazhina, Tappan, NY (US); U.S. PATENT DOCUMENTS George Joseph Donato, III, Swarthmore, PA (US); Steven R. 3,714,159 A 1/1973 Janssen et al. Fabian, Barnegat, NJ (US); John 3,723.440 A 3, 1973 Freter et al. 3,854,480 A 12/1974 Zaffaroni Lokhnauth, Fair Lawn, NJ (US); 3,884,916 A 5, 1975 Janssen et al. Sreenivasulu Megati, New City, NY 3,937,801 A 2/1976 Lippmann (US); Charles Melucci, Highland Mills, 3.996,214 A 12/1976 Dajani et al. NY (US); Christian Ofslager, 4.012,393 A 3, 1977 Markos et al. 4,013,668 A 3, 1977 Adelstein et al. Newburgh, NY (US); Niketa Patel, 4,025,652 A 5, 1977 Diamond et al. Lincoln Park, NJ (US); Galen 4,060.635 A 11/1977 Diamond et al. Radebaugh, Chester, NJ (US); Syed M. 4,066,654 A 1/1978 Adelstein et al. Shah, East Hanover, NJ (US); Jan 4,069,223. A 1/1978 Adelstein Szeliga, Croton On Hudson, NY (US); 4,072,686 A 2f1978 Adelstein et al. Huyi Zhang, Garnerville, NY (US); (Continued) Tianmin Zhu, Monroe, NY (US) FOREIGN PATENT DOCUMENTS (73) Assignee: Wyeth, LLC, Madison, NJ (US) AU 610 561 B2 8, 1988 (*) Notice: Subject to any disclaimer, the term of this AU T58416 B2 3, 2003 patent is extended or adjusted under 35 (Continued) U.S.C. -
Opioid Receptorsreceptors
OPIOIDOPIOID RECEPTORSRECEPTORS defined or “classical” types of opioid receptor µ,dk and . Alistair Corbett, Sandy McKnight and Graeme Genes encoding for these receptors have been cloned.5, Henderson 6,7,8 More recently, cDNA encoding an “orphan” receptor Dr Alistair Corbett is Lecturer in the School of was identified which has a high degree of homology to Biological and Biomedical Sciences, Glasgow the “classical” opioid receptors; on structural grounds Caledonian University, Cowcaddens Road, this receptor is an opioid receptor and has been named Glasgow G4 0BA, UK. ORL (opioid receptor-like).9 As would be predicted from 1 Dr Sandy McKnight is Associate Director, Parke- their known abilities to couple through pertussis toxin- Davis Neuroscience Research Centre, sensitive G-proteins, all of the cloned opioid receptors Cambridge University Forvie Site, Robinson possess the same general structure of an extracellular Way, Cambridge CB2 2QB, UK. N-terminal region, seven transmembrane domains and Professor Graeme Henderson is Professor of intracellular C-terminal tail structure. There is Pharmacology and Head of Department, pharmacological evidence for subtypes of each Department of Pharmacology, School of Medical receptor and other types of novel, less well- Sciences, University of Bristol, University Walk, characterised opioid receptors,eliz , , , , have also been Bristol BS8 1TD, UK. postulated. Thes -receptor, however, is no longer regarded as an opioid receptor. Introduction Receptor Subtypes Preparations of the opium poppy papaver somniferum m-Receptor subtypes have been used for many hundreds of years to relieve The MOR-1 gene, encoding for one form of them - pain. In 1803, Sertürner isolated a crystalline sample of receptor, shows approximately 50-70% homology to the main constituent alkaloid, morphine, which was later shown to be almost entirely responsible for the the genes encoding for thedk -(DOR-1), -(KOR-1) and orphan (ORL ) receptors. -
Mu-0Pio:Id Receptor Is Involved in P Endorphin- Induced Feeding in Goldfish
Peptides, Vol. 17, No. 3, pp. 421-424, 1996 Copyright 0 1996 Elsevier Science Inc. Printed in the USA. All rights reserved 0196-9781196 $15.00 + .@I PIISO196-9781(96)00006-X Mu-0pio:id Receptor Is Involved in P_Endorphin- Induced Feeding in Goldfish NURIA DE PEDRO,’ MARiA VIRTUDES &PEDES, MA&A JESrjS DELGADO AND MERCEDES ALONSO-BEDATE Departamento de Biologia Animal II (Fisiologfa Animal), Facultad de Ciencias Biolbgicas, Universidad Complutense, 28040 Madrid, Spain Received 7 September 1995 DE PEDRO, N., M. V. Cl%PEDES, M. J. DELGADO AND M. ALONSO-BEDATE. Mu-opioid receptor is involved in p- endorphin-inducea'feeding in goldjsh. PEPTIDES 17( 3) 421-424, 1996.-The present study evaluated the central effects of selective opioid receptor subtype agonists and antagonists on food intake in satiated goldfish. Significant increases in feeding behavior occurred .m goldfish injected with P-endorphin, the kappa agonist, U-50488, the delta agonist, [D-Pen’,D-Pen5]enkephalin (DPEN), and the mu agonist, [o-Ala’,N-Me-Phe4,Gly5-ollenkephalin (DAMGO). On the other hand, the different receptor antagonists used: nor-binaltorphamine (nor-BNI) for kappa, 7-benzidilidenenaltrexone (BNTX) for delta,, naltriben for delta,, @imaltrexamine (P-FNA) for mu, and naloxonazine for mu,, by themselves, did not modify ingestion or slightly reduced it. The feeding stimulation by P-endorphin was antagonized by P-FNA and naloxonazine, but not by nor-BNI, BNTX, or naltriben. These data indicate that the mu-opioid receptor is involved in the modulation of the feeding behavior in goldfish. P-Endorphin Food intake Goldfish Opioid receptors Opioid antagonists Mu receptor Delta receptor Kappa receptor THE role of the endogenous opioid system in the regulation of kappa receptor subtypes (34) makes it difficult to identify the ingestive behavior is we:11 established (5,22,25). -
Opioids and Nicotine Dependence in Planarians
Pharmacology, Biochemistry and Behavior 112 (2013) 9–14 Contents lists available at ScienceDirect Pharmacology, Biochemistry and Behavior journal homepage: www.elsevier.com/locate/pharmbiochembeh Opioid receptor types involved in the development of nicotine physical dependence in an invertebrate (Planaria)model Robert B. Raffa a,⁎, Steve Baron a,b, Jaspreet S. Bhandal a,b, Tevin Brown a,b,KevinSongb, Christopher S. Tallarida a,b, Scott M. Rawls b a Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA b Department of Pharmacology & Center for Substance Abuse Research, Temple University School of Medicine, Philadelphia, PA, USA article info abstract Article history: Recent data suggest that opioid receptors are involved in the development of nicotine physical dependence Received 18 May 2013 in mammals. Evidence in support of a similar involvement in an invertebrate (Planaria) is presented using Received in revised form 18 September 2013 the selective opioid receptor antagonist naloxone, and the more receptor subtype-selective antagonists CTAP Accepted 21 September 2013 (D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH )(μ, MOR), naltrindole (δ, DOR), and nor-BNI (norbinaltorphimine) Available online 29 September 2013 2 (κ, KOR). Induction of physical dependence was achieved by 60-min pre-exposure of planarians to nicotine and was quantified by abstinence-induced withdrawal (reduction in spontaneous locomotor activity). Known MOR Keywords: Nicotine and DOR subtype-selective opioid receptor antagonists attenuated the withdrawal, as did the non-selective Abstinence antagonist naloxone, but a KOR subtype-selective antagonist did not. An involvement of MOR and DOR, but Withdrawal not KOR, in the development of nicotine physical dependence or in abstinence-induced withdrawal was thus Physical dependence demonstrated in a sensitive and facile invertebrate model. -
Tolerance to Μ-Opioid Agonists in Human Neuroblastoma SH-SY5Y
British Journal of Pharmacology (1997) 121, 1422 ± 1428 1997 Stockton Press All rights reserved 0007 ± 1188/97 $12.00 Tolerance to m-opioid agonists in human neuroblastoma SH-SY5Y cells as determined by changes in guanosine-5'-O-(3-[35S]-thio)triphosphate binding Jackie Elliott, Li Guo & 1John R. Traynor Department of Chemistry, Loughborough University, Leics., LE11 3TU and Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, 48109, U.S.A. 1 The agonist action of morphine on membranes prepared from human neuroblastoma SH-SY5Y cells was measured by an increase in the binding of the GTP analogue [35S]-GTPgS. Morphine increased the 35 71 binding of [ S]-GTPgS to SH-SY5Y cell membranes by 30 fmol mg protein with an EC50 value of 76+10 nM. 2 Incubation of SH-SY5Y cells with 10 mM morphine for 48 h caused a tolerance to morphine manifested by a 2.5 fold shift to the right in the EC50 value with a 31+6% decrease in the maximum stimulation of [35 S]-GTPgS binding. The response caused by the partial agonist pentazocine was reduced to a greater extent. 3 Chronic treatment of the cells with the more ecacious m-ligand [D-Ala2, MePhe4, Gly-ol5]enkephalin (DAMGO, 10 mM) for 48 h aorded a greater eect than treatment with morphine. The maximal agonist eect of morphine was reduced to 58.9+6% of that seen in control cells while the maximal eect of DAMGO was reduced to 62.8+4%. There was a complete loss of agonist activity for pentazocine. -
The Opioid Crisis and the Black/African American Population: an Urgent Issue
THE OPIOID CRISIS AND THE BLACK/AFRICAN AMERICAN POPULATION: AN URGENT ISSUE THE OPIOID CRISIS AND THE BLACK/AFRICAN AMERICAN POPULATION: AN URGENT ISSUE U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Office of Behavioral Health Equity Table of Contents Introduction ...................................................................................................................................................... 3 i. Purpose of the Issue Brief ........................................................................................................................ 3 ii. Sources of Information ............................................................................................................................ 4 Opioids in Black/African American Communities: Context .................................................................. 4 i. What Do the National Data Show? ........................................................................................................ 4 ii. Routes to Opioid Misuse and Overdose Deaths: Pain Management, Illicit Drug Use, and Opioid Comorbidities in Black/African American Communities .................................................... 6 iii. Challenges to Prevention, Treatment, and Recovery .......................................................................... 7 Strategies to Address Opioid Misuse and OUD in Black/African American Communities ............ 9 i. Standard Treatment ................................................................................................................................ -
Adrenoceptor (1) Antibiotic (2) Cyclic Nucleotide (4) Dopamine (5) Hormone (6) Serotonin (8) Other (9) Phosphorylation (7) Ca2+
Supplementary Fig. 1 Lifespan-extending compounds can show structural similarity or have common substructures. Cl NO2 H doxycycline (2) N N NH 2 O H O H O O H O O O O O H O NH NH Cl O O 2 N N guanfacine (1) O H N N H H H nitrendipine (3) S Cl N H promethazine (9) NO2 F N NH2 F N demeclocycline (2) O H O O H O O F N NH O O H O O Cl S N NH N guanabenz (1) O O 2 fluphenthixol (5) Br CN O H N H N nicardipine (3) S N H Cl O H N N propionylpromazine (5) O O H O H O O H O O O H Cl N S Br LFM−A13 (7) NH2 S S O H H H chlorprothixene (5) thioridazine (5) N N O H minocycline (2) HO S O β-estradiol (6) O H H N H N H O H O danazol (6) N N cyproterone (6) H N H O H O methylergonovine (5) HO H pergolide (5) O N O O O N O HN O O H O N N H 3C H H O O H Cl H O H C H 3 O H N N H N H N H H O metergoline (8) dihydroergocristine (5) Cortexolone (5) HO O N (R,R)−cis−Diethyltetrahydro−2,8−chrysenediol (6) O H O H N O vincristine (9) N H N HN H O H H N H O N N N N O N H O O O N N dihydroergotamine (8) H O Cl O H O H O nortriptyline (1) S O mianserin (8) octoclothepin (5) loratadine (9) H N N Cl N N N cinnarizine (3) O N N N H Cl N Cl N N N O O N loxapine (5) N amoxapine (1) oxatomide (9) O O Adrenoceptor (1) Antibiotic (2) Ca2+ Channel (3) Cyclic Nucleotide (4) Dopamine (5) Hormone (6) Phosphorylation (7) Serotonin (8) Other (9) Supplementary Fig. -
Phencyclidine: an Update
Phencyclidine: An Update U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • Public Health Service • Alcohol, Drug Abuse and Mental Health Administration Phencyclidine: An Update Editor: Doris H. Clouet, Ph.D. Division of Preclinical Research National Institute on Drug Abuse and New York State Division of Substance Abuse Services NIDA Research Monograph 64 1986 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administratlon National Institute on Drug Abuse 5600 Fishers Lane Rockville, Maryland 20657 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, DC 20402 NIDA Research Monographs are prepared by the research divisions of the National lnstitute on Drug Abuse and published by its Office of Science The primary objective of the series is to provide critical reviews of research problem areas and techniques, the content of state-of-the-art conferences, and integrative research reviews. its dual publication emphasis is rapid and targeted dissemination to the scientific and professional community. Editorial Advisors MARTIN W. ADLER, Ph.D. SIDNEY COHEN, M.D. Temple University School of Medicine Los Angeles, California Philadelphia, Pennsylvania SYDNEY ARCHER, Ph.D. MARY L. JACOBSON Rensselaer Polytechnic lnstitute National Federation of Parents for Troy, New York Drug Free Youth RICHARD E. BELLEVILLE, Ph.D. Omaha, Nebraska NB Associates, Health Sciences Rockville, Maryland REESE T. JONES, M.D. KARST J. BESTEMAN Langley Porter Neuropsychiatric lnstitute Alcohol and Drug Problems Association San Francisco, California of North America Washington, D.C. DENISE KANDEL, Ph.D GILBERT J. BOTV N, Ph.D. College of Physicians and Surgeons of Cornell University Medical College Columbia University New York, New York New York, New York JOSEPH V. -
The Impact of Cannabis Access Laws on Opioid Prescribing
Journal of Health Economics 69 (2020) 102273 Contents lists available at ScienceDirect Journal of Health Economics j ournal homepage: www.elsevier.com/locate/econbase The impact of cannabis access laws on opioid prescribing a,∗ b c Benjamin J. McMichael , R. Lawrence Van Horn , W. Kip Viscusi a Assistant Professor of Law, University of Alabama School of Law, Box 870382, 101 Paul W. Bryant Drive East, Tuscaloosa, AL, 35487, United States b Associate Professor of Management and Law, Executive Director of Health Affairs, Owen Graduate School of Management, Vanderbilt University, 401 21st Avenue South, Nashville, TN, 37203, United States c University Distinguished Professor of Law, Economics, and Management, Vanderbilt University Law School. 131 21st Avenue South, Nashville, TN, 37203, United States a r a t i c l e i n f o b s t r a c t Article history: While recent research has shown that cannabis access laws can reduce the use of prescrip- Received 5 October 2018 tion opioids, the effect of these laws on opioid use is not well understood for all dimensions Received in revised form 17 July 2019 of use and for the general United States population. Analyzing a dataset of over 1.5 bil- Accepted 7 December 2019 lion individual opioid prescriptions between 2011 and 2018, which were aggregated to the Available online 14 December 2019 individual provider-year level, we find that recreational and medical cannabis access laws reduce the number of morphine milligram equivalents prescribed each year by 11.8 and 4.2 JEL classification: percent, respectively. These laws also reduce the total days’ supply of opioids prescribed, I180 the total number of patients receiving opioids, and the probability a provider prescribes K19 any opioids net of any offsetting effects.